Transfusion of packed red blood cells in adults with sickle cell anemia treated at an emergency hospital

SUMMARY OBJECTIVE: The aim of this study was to analyze the prescription of packed red blood cells performed by emergency physicians for adults with sickle cell anemia. METHODS: Transfusions performed in adults with sickle cell anemia treated at an emergency service in São Bernardo do Campo, São Paulo Brazil, between January 2018 and January 2022 were evaluated. For data comparison, the chi-square2 test was used. The significance level adopted was 5%. RESULTS: A total of 114 transfusions were performed. The mean age was 41.8±16.4 years, and pretransfusion hemoglobin was 6.1±1.23 g/dL. Regarding the indication, the adequacy of transfusions performed in symptomatic individuals was significantly higher compared to asymptomatic individuals (100% vs. 3.9%, p<0.001). Symptomatic individuals received excessive volumes of packed red blood cells less frequently than asymptomatic individuals (17.5% vs. 56.9%, p<0.001). The filtered subtype, indicated for sickle cell anemia, was prescribed in only a quarter of the patients. However, non-indicated subtypes were frequently prescribed. CONCLUSION: This study found low adequacy in the indication and calculation of the transfusion volume of packed red blood cells in asymptomatic individuals. Few patients received filtered red blood cells, resulting in increased risks of transfusion reactions. On the contrary, non-indicated subtypes were prescribed in a quarter of transfusions, which resulted in higher costs and delay in receiving packed red blood cells.

ABO and rhesus blood group frequency among donors and admitted patients at Zawia Medical Center, AzZawya City, Libya

The identification and categorization of blood groups play a crucial role in transfusion medicine as it allows for safe and compatible transfusions. Among the various blood group systems, the ABO and Rhesus blood grouping systems have special clinical significance. Understanding the distribution and frequency of ABO and Rhesus blood groups within a specific community is essential for healthcare planning, especially when it comes to blood supply management and organ transplantation. Additionally, studies have also shown a relationship between ABO blood groups and the onset and spread of diseases. Therefore, this study was conducted to detect the distribution and frequency of ABO and Rhesus blood groups in AzZawya City, Libya. In this retrospective study, data from the blood bank at Zawia Medical Center were collected over three years to detect the distribution of ABO and Rh blood groups among 5187 donors and admitted patients. The result shows that blood group O is the dominant among all study subjects (45%), as well as, among males (48.2%), and females (42.2%). Blood group A is the second most common at 34.6% among total, 33% among males, and 36% among females. For Rhesus antigens 89.4% of study subjects were Rhesus positive, 87.3% for males and 80% for females. In addition, the results show a statistically significant association between gender and blood group distribution p <0.001. Knowing the most common blood types helps maintain adequate blood bank supplies.

Knowledge, attitudes and practices of resident doctors and interns on safe blood transfusion practices: a survey-based study

ABSTRACT Introduction: The knowledge of clinicians regarding blood transfusion services may impact patient care and transfusion outcome. The wide variation in transfusion practices among clinicians leads to inappropriate blood product usage and jeopardizes patient safety. Hence, this survey study aimed to assess knowledge, attitude and practice among the residents and interns of safe blood transfusion. Methods: The online survey was based on self-administered questionnaires of three sections: 1. Demography; 2. Knowledge, and; 3. Attitude and Practice. One point was assigned for the correct response of each question in every section. The knowledge score was further categorized into three categories, depending on the points obtained. The participants were also divided into four groups, depending on their experience. The Kruskal-Wallis test was applied to determine the difference of knowledge and practice scores in three designated groups of residents and interns. A p-value of less than 0.05 was considered to be significant. Result: A total of 247 residents and interns participated in this study. Thirteen participants had an incomplete response. Out of 234 participants, Senior Residents (SR), Junior Residents (JR), and interns were 70, 96 and 68 participants, respectively. The knowledge scores of interns were significantly low, as compared to SRs and JRs. Practice scores of interns were also significantly low, compared to the JRs. However, most of the residents and interns (85%) were aware of the pre-transfusion testing. Conclusion: Therefore, the mandatory incorporation of the transfusion medicine subject in the undergraduate curriculum can help the young budding doctors to better implement the patient blood management.

La formación y especialización médica en medicina transfusional / Medical training and specialization in transfusion medicine

Introducción: Para una práctica transfusional segura se requiere una formación en medicina transfusional. Objetivo: Determinar la manera en que se integran los contenidos y las habilidades de medicina transfusional en la formación y la especialización médica en Cuba. Métodos: Se hizo un estudio educacional, analítico, de corte transversal en la Universidad de Ciencias Médicas de Camagüey, desde marzo de 2020 hasta julio de 2021. Se realizó un análisis documental para precisar cómo se integraban los contenidos y las habilidades de medicina transfusional al currículo para la formación de médicos, a los programas de estudio del internado vertical en 26 especialidades médicas, y a 29 planes de estudio y programas de especialización en Cuba. Resultados: El currículo para la formación de médicos en Cuba no incluye medicina transfusional. La asignatura que más contribuye a la formación en esta área del saber es Sangre y Sistema inmune. Los contenidos y las habilidades de medicina transfusional solo se incluyen expresamente en nueve programas de estudio del internado vertical y en 12 planes de estudio y programas de especialización. Conclusiones: Existe una insuficiente integración de los contenidos y las habilidades de medicina transfusional en el currículo de la carrera de medicina en Cuba, situación que se manifiesta también en los programas de estudios de los internados verticales y en la mayoría de los programas de las especialidades médicas.

Introduction: Safe transfusion practice requires training in transfusion medicine. Objective: To determine the way in which transfusion medicine contents and skills are integrated into medical training and specialization in Cuba. Methods: An educational, analytical and cross-sectional study was carried out at Universidad de Ciencias Médicas de Camagüey, from March 2020 to July 2021. A documentary analysis was conducted to determine how transfusion medicine contents and skills were integrated into the curriculum for the training of physicians, into the study programs of the vertical internship in 26 medical specialties, as well as into 29 study plans and specialization programs in Cuba. Results: The curriculum for the training of physicians in Cuba does not include transfusion medicine. The subject that most contributes to training in this area of knowledge is Blood and Immune System. Transfusion medicine contents and skills are only expressly included in nine vertical internship study programs and in twelve study plans and specialization programs. Conclusions: There is insufficient integration of transfusion medicine contents and skills in the Cuban medical major curriculum, a situation that is also manifested in the study programs of vertical internships and in most of the medical specialties programs.

Design and simulate routine serologic training experiments in blood transfusion using RhD blood group / 中国输血杂志

【Objective】 To design and simulate routine serological experiments in transfusion techniques using RhD blood group, so as to solve the problem of difficult to obtain positive specimens in experimental teaching. 【Methods】 RhD positive red blood cells, RhD negative red blood cells and anti-D reagent were used to design and simulate the enzyme treatment experiment, absorption and elution test, antibody identification experiment and cross matching experiment of polybrene technology in transfusion techniques. 【Results】 Papain treatment of red blood cells made the agglutination of RhD positive red blood cells and IgG anti-D visible. Absorption and elution test were successfully simulated with RhD positive red blood cells and IgG anti-D reagent. The antibody identification of anti-Jka and anti-Fya was successfully simulated by creating different identification panel and panel cells made by RhD positive cells and negative cells. Cross matching test of polybrene method can also be simulated using RhD negative and positive red blood cells and IgG anti-D reagent. 【Conclusion】 RhD blood group can be used to simulate most of the routine serological experiments of blood transfusion, which can be used in the serological laboratory teaching of transfusion.

Application of traditional teaching combined with PBL in the teaching of transfusion medicine——taking Clinical Blood Transfusion Testing Technique as an example / 中国输血杂志

【Objective】 To explore the application effect of traditional teaching combined with problem based learning (PBL) in the teaching of transfusion medicine taking the chapter of Human Leukocyte Antigen System and Testing in Clinical Blood Transfusion Testing Technique as an example. 【Methods】 Firstly, practical problems in chapter Human Leukocyte Antigen System and Testing were analyzed. Then, in response to the key and difficult points in the teaching of this chapter, examples were given to illustrate the practical application of traditional teaching combined with PBL in the teaching of Clinical Blood Transfusion Testing Technique from the aspects of teaching objectives, teaching processes, course implementation and implementation effects. The teaching effectiveness was evaluated through a questionnaire. 【Results】 Traditional teaching combined with PBL helped students grasp important knowledge and techniques, break down thinking barriers, grasp internal connections and characteristics, simplify the learning process, stimulate interest in learning and enhance team collaboration. Meanwhile, students' exploration and innovation abilities could be further cultivated through extracurricular expansion by teachers, thus achieving ideal teaching effect. The questionnaire showed that over 90% of the students consider that combining traditional teaching with PBL was beneficial for improving teaching effect. 【Conclusion】 In the teaching of transfusion medicine, adopting traditional teaching combined with PBL according to the textbook content can improve the teaching effect, which is beneficial for the cultivation of comprehensive talents.

Uso de componentes sanguíneos en el Hospital Docente Provincial Oncológico María Curie en Camagüey / Use of blood components at the Oncologica l University Hospital Marie Curie of Camagüey

Introducción: La comunidad médica en muchas partes del mundo está preocupada porque se indica realizar más transfusiones que lo recomendado. La transfusión de sangre alogénica se ha considerado erróneamente un procedimiento exento de peligros y con beneficios indiscutibles; además, no es una forma totalmente segura para tratar la anemia asociada al cáncer. Objetivo: Analizar el consumo de componentes sanguíneos en el Hospital Docente Provincial Oncológico María Curie en Camagüey. Métodos: Estudio descriptivo, longitudinal, retrospectivo, sustentado en el análisis del consumo hospitalario de componentes sanguíneos en el período enero 2018 a diciembre 2021. Las variables analizadas fueron: cantidad mensual de unidades transfundidas de componentes sanguíneos, celulares y plasmáticos; el total de pacientes ingresados y transfundidos y la tasa de hemoterapia por cada 1000 ingresos hospitalarios. Resultados: El concentrado de eritrocitos fue el componente sanguíneo más solicitado en el período desde 2018 hasta 2021 (excepto en tres meses). La tasa de hemoterapia se mantuvo por encima de 245 hemocomponentes transfundidos por cada 1000 pacientes ingresados. Conclusiones: El consumo de hemocomponentes, según el cumplimiento de la tasa de hemoterapia, fue evaluado de mal en los años desde 2018 hasta 2021. Se sugiere mejorar la seguridad del paciente y la calidad de la asistencia médica con la aplicación imprescindible del método clínico, la preparación en medicina transfusional, el establecimiento de los consensos de criterios que sirvan de guía para el tratamiento de la anemia asociada a cáncer y la atención centrada en el paciente (tratamientos personalizados).

Introduction: Around the world, the Medical Community concerned with blood transfusions being recommended more than it is indicated. Allogenic blood transfusions have been erroneously considered as a safe procedure with unquestionable benefits; as well as it is not completely safe for cancer anemia treatment. Objective: To analyse the use of blood components at the Oncological Hospital Marie Curie of Camagüey Method: Longitudinal, descriptive study, retrospectively sustained in the analysis of the consumption of blood components at the hospital from January 2018 to December 2021. Analysed variables were the monthly quantity of transfused units, cellular and plasma, blood products, total of admitted patients, total transfused patients and haemotherapy rate for each 1000 patients admitted at the hospital. Results: Red blood cells were the most requested components during the study period. From 2018 to 2021 (except three months). Haemotherapy rate stayed above 245 blood component transfused by each 1000 admitted patients. Conclusions: According to compliance with the haemotherapy rate, the use of blood components was evaluated unfavorably in analyzed period. With the indispensable application of the clinical method, education in transfusion medical practice, the consensus criteria as a guide for anemia cancer treatment, and patient-centered attention (personalized treatments), will improve the patient's safety and the quality of the medical treatment.

Funciones de enfermería en los procederes de aféresis / Nursing functions in cell therapy procedures

Introducción: Con el paso de los años, la profesión de enfermería ha ganado terreno en diferentes áreas de la medicina y su acción ha llegado a esferas que se creía exclusivas de otros profesionales del sector de la salud, como la Medicina Transfusional y Terapia celular. Objetivo: Describir las funciones de enfermería en los procederes de aféresis. Análisis y síntesis de la información: El trabajo de enfermería se basa en la aplicación de la metodología para la implementación de los cuidados que realiza. El intercambio directo con la persona permite identificar sus necesidades, facilita planear, controlar, ejecutar y evaluar las actividades que se realizan en la práctica diaria. Dentro del área de la Medicina Transfusional el accionar de enfermería es fundamental, ya que puede intervenir en diferentes fases del proceso de la donación de sangre, realiza la centrifugación del componente a obtener, transfunde o implanta componentes sanguíneos y atiende las reacciones adversas del individuo. Conclusiones: La acción de enfermería en la actividad de aféresis para diferentes procedimientos es primordial para preservar la salud del donante y el paciente, así como en la creación o modificación de protocolos de trabajo con mayor eficiencia, eficacia y efectividad en base a los conocimientos y la experiencia en este campo lo que genera una espiral de desarrollo continuo que obliga a la constante actualización en el tema.

Introduction: With the step of the years, the infirmary profession has won land in different areas of the medicine and its action has arrived to spheres that it was believed they were exclusive of other professionals of the sector of the health, as the Medicine Transfusional and cellular Therapy. Objective: to describe the nursing functions in the aphaeresis procedures. Analysis and synthesis of the information: The infirmary work is based on the application of the methodology for the implementation of the cares that he/she carries out. The direct exchange with the patient allows to identify its necessities, as well as it facilitates to drift, to control, to execute and to evaluate the activities that are carried out in the daily practice. Inside the area of the transfusion medicine working of infirmary is fundamental, since it can intervene in different phases of the process of the donation of blood, he/she carries out the centrifugation of the component to obtain, it transfuses or it implants sanguine components and he/she assists the patient's adverse reactions. Conclusions: The nurse action in the aphaeresis activity for different procedures is primordial to preserve the donor's health and the patient, as well as in the creation or modification of work protocols with bigger efficiency, effectiveness and effectiveness based on the knowledge and the experience in this field what generates a hairspring of continuous development that he/she forces to the constant bring up to date in the topic.

Tromboelastometría rotacional, el electrocardiograma de la coagulación / Rotational thromboelastometry. The electrocardiogram of coagulation

Resumen: La tromboelastometría evalúa los cambios viscoelásticos en el proceso de coagulación. Nos ofrece una representación gráfica de la formación del coágulo, la estabilidad del mismo y la presencia de lisis. La tromboelastometría rotacional es una herramienta diagnóstica que representa de forma gráfica la funcionalidad del coágulo para un manejo dirigido e individualizado de la coagulopatía asociada a hemorragia. En este trabajo se puntualiza cómo la tromboelastometría rotacional es a la coagulación como el electrocardiograma es al corazón.

Abstract: Thromboelastometry evaluates viscoelastic changes in the coagulation process. It offers us a graphic representation of the formation of the clot, its stability and the presence of lysis. Rotational thromboelastometry is a diagnostic tool that graphs the functionality of the clot, for a targeted and individualized management of bleeding-associated coagulopathy. In this work it is specified how rotational thromboelastometry is to coagulation as the electrocardiogram is to the heart.

Implementation of a patient blood management program based on a low-income country-adapted clinical decision support system

ABSTRACT Introduction: Patient blood management (PBM) programs are associated with better patient outcomes, a reduced number of transfusions and cost-savings The Clinical Decision Support (CDS) systems are valuable tools in this process, but their availability is limited in developing countries This study assesses the feasibility and effectiveness of an adapted CDS system for low-income countries. Methods: This was a prospective study of the PBM program implementation, in a 200-bed tertiary hospital, between February 2019 and May 2020. Outcome measures were red blood cell (RBC), fresh frozen plasma (FFP) and platelet unit transfusions, the transfusion of a single unit of red blood cells and an RBC adequacy index (RAI). Results: Comparing the post-PBM program era with the pre-PBM system era, there was a decrease in red blood cell transfusions (p = 0.05), with an increase in single unit red blood cell transfusions (p = 0.005) and RAI (p < 0.001). Conclusions: The PBM programs, including electronic transfusion guidelines with pre-transfusion medical auditing, was associated with improved transfusion practices and reduced product acquisition-related costs.

Analysis of the main research directions in transfusion of the U. S.military based on ClinicalTrials.gov data / 中国输血杂志

【Objective】 To explore the main development directions and research progress of blood transfusion in the U. S.military based on ClinicalTrials.gov. 【Methods】 The literature of clinical trials related to field transfusion medicine from 2002 to 2021 were retrieved based on www.clinicaltrials.gov with "United States Department of Defense" , "U.S.Army Medical Research and Development Command" and "United States Naval Medical Research Center" as the search terms, and the main characteristics were analyzed in terms of research progress, clinical stage, task allocation, regional distribution, research contents and results. 【Results】 A total of 931 clinical trials were retrieved, of which 16 were closely related to field blood transfusion medicine.Among them, pathogen reduction/inactivation of whole blood, platelet transfusion, plasma transfusion, whole blood transfusion and other types of researches accounted for 25% (4/16), 25% (4/16), 25% (4/16), 18.75 (3/16) and 6.25% (1/16), respectively.The U. S.military focused on the new technological breakthroughs in blood safety and blood storage, the evaluation of the countershock therapy, the application of whole blood early transfusion and the civil-military inosculation in research. 【Conclusion】 This study, based on ClinicalTrials.gov data, redounds to understand the research progress and current situation of the U. S.military field blood transfusion medicine.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Ciencias básicas en el proceso docente del técnico superior en Análisis Clínico y Medicina Transfusional / Basic sciences in the teaching process of the lab technician in Clinical Analysis and Transfusion Medicine

RESUMEN Fundamento: el diseño curricular debe partir de las exigencias sociales; este permite la determinación de las cualidades a alcanzar por el egresado y la estructura organizacional del proceso docente a nivel de carrera. Objetivo: valorar la importancia de las ciencias básicas en el plan del proceso docente del técnico superior en Análisis Clínico y Medicina Transfusional, por su influencia en la formación laboral del futuro egresado. Métodos: se realizó una investigación documental en el período comprendido entre septiembre y noviembre de 2019 en la Universidad de Ciencias Médicas de Camagüey. Se emplearon métodos teóricos: análisis-síntesis e inductivo-deductivo; y empíricos: el análisis documental a partir del cual se realizaron valoraciones cualitativa y cuantitativa del plan del proceso docente del técnico superior en Análisis Clínico y Medicina Transfusional. Resultados: en el plan del proceso docente de esta carrera no aparecen las asignaturas clasificadas por ciclos y se evidencia una disminución considerable del ciclo básico. Conclusiones: la valoración realizada evidencia que falta precisión del papel que juega cada ciclo de las asignaturas en el plan del proceso docente, lo que influye negativamente en su cientificidad y se demuestra que tiene una elevada carga laboral, ya que el estudiante desde sus primeros años se encuentra vinculado al trabajo diario en el servicio asistencial en el que adquiere habilidades propias de la profesión.

ABSTRACT Background: curricular design must start from social demands; this allows the determination of the qualities to be achieved by the graduate and the organizational structure of the teaching process at degree level. Objective: to assess the importance of basic sciences in the plan of the teaching process of the lab technician in Clinical Analysis and Transfusion Medicine, due to its influence on the job training of future graduates. Methods: a documentary research was carried out in the period from September to November 2019 at Camagüey University of Medical Sciences. Theoretical methods were used: analysis-synthesis and inductive-deductive; and empirical ones: the documentary analysis from which qualitative and quantitative evaluations were made of the plan of the teaching process of the lab technician in Clinical Analysis and Transfusion Medicine. Results: in the plan of the teaching process of this degree, the subjects classified by cycles do not appear and there is a considerable decrease in the basic cycle. Conclusions: the assessment carried out shows that there is a lack of precision in the role that each cycle of the subjects play in the plan of the teaching process, which negatively influences its scientific approach and shows that it has a high workload, since the student from its early years is linked to daily work in the healthcare service in which it acquires distinctive skills of the profession.

Elementos de las competencias en medicina transfusional para la especialidad Anestesiología y Reanimación / Elements of transfusion medicine competencies in Anesthesiology and Reanimation

Introducción: El desempeño competente del personal médico en medicina transfusional implica profundos conocimientos que no recibe durante el proceso formativo. Objetivo: Identificar elementos para la normalización de la competencia en medicina transfusional para la especialidad Anestesiología y Reanimación. Métodos: Estudio educacional de corte transversal. Se realizó un análisis documental sobre normalización de las competencias profesionales en Cuba y sobre los componentes de la competencia en medicina transfusional para la especialidad. Asimismo, se examinaron los contenidos y habilidades de medicina transfusional en el programa de la residencia. Finalmente, fueron entrevistados profesores de la especialidad. Resultados: La competencia abarca conocimientos sobre riesgos de transmisión de infecciones al paciente, prescripción segura de componentes sanguíneos, reconocimiento de las reacciones transfusionales, ejecución y enseñanza al no graduado de los procedimientos para la transfusión de sangre alogénica. Implica conocer y actualizarse en los aspectos éticos, científicos y legales involucrados. Incluye demostrar conocimientos, habilidades y valores para la preparación preoperatoria de los pacientes con anemia, riesgo hemorrágico y otras enfermedades hematológicas, para el empleo de alternativas y para el ahorro de componentes sanguíneos. Los profesores reconocieron que al comenzar la residencia es necesario un entrenamiento, para luego poder realizar una práctica transfusional segura. Conclusiones: Ser competente en medicina transfusional, subdisciplina de la especialidad Anestesiología y Reanimación, demanda movilizar un conjunto de conocimientos, habilidades, actitudes y valores de manera simultánea, interrelacionada y oportuna para transfundir menos y mejor, con más seguridad y menor costo(AU)

Introduction: Competent performance by the health care personnel in transfusion medicine implies deep knowledge not received during training. Objective: Identify elements of competence standardization in transfusion medicine for the specialty of anesthesiology and resuscitation. Methods: A cross-sectional educational study was conducted. A document analysis was carried out about standardization of professional competences in Cuba and about the components of competence in transfusion medicine for the specialty. Examination was also performed of transfusion medicine contents and skills in the residency program. Finally, professors from the specialty were interviewed. Results: Competence comprises knowledge about risks for the transmission of infections to patients, safe prescription of blood components, identification of transfusion reactions, and performance of and undergraduate training in allogeneic blood transfusion procedures. It implies knowledge and updated awareness of the ethical, scientific and legal aspects involved. It includes demonstrating knowledge, skills and values related to preoperative preparation of patients with anemia, hemorrhagic risk and other hematologic diseases, to use alternatives and save blood components. The professors recognized that training is required at the start of the residency program to ensure the performance of safe transfusion practices. Conclusions: Being competent in transfusion medicine, a subdiscipline of the specialty of Anesthesiology and Resuscitation, requires mobilization of a set of knowledge, skills, attitudes and values in a simultaneous, interrelated and timely fashion to transfuse less but better, with greater safety and at a lower cost(AU)

Practice and exploration of a new mode of orientation practice for undergraduate students majoring in blood transfusion medicine / 中华医学教育探索杂志

To cultivate high-quality professionals of transfusion medicine and construct a new mode of undergraduate practice of transfusion medicine. Since 2013, orientation interns in blood transfusion medicine were recruited from the undergraduate program of laboratory medicine, and a new teaching mode of orientation practice of blood transfusion medicine was established from the aspects of teaching staff, rotation of posts, practice content and comprehensive quality. Through the new training mode of orientation practice, excellent transfusion medical professionals with solid basic knowledge, strong operational skills and high comprehensive quality were cultivated. The establishment of the oriented practice mode of blood transfusion medicine is beneficial to the cultivation and output of high-quality transfusion talents and plays a positive role in promoting the development of transfusion medicine education.

Seropositivity of HIV and associated factors in donors of a blood bank in the city of Medellin - Colombia, 2005 - 2018 / Seropositividad de vih y factores asociados en donantes de un banco de sangre de la ciudad de medellín - colombia, 2005 - 2018

RESUMEN El objetivo de esta investigación fue estimar la seropositividad de VIH y factores asociados en donantes de un banco de sangre de la ciudad de Medellín - Colombia, 2005 - 2018. Se realizó un estudio transversal en 166 603 donantes del banco de Sangre de la Escuela de Microbiología de la Universidad de Antioquia. Las estimaciones se basaron en proporciones y razones de odds con sus intervalos de confianza del 95 %. La mayoría de donantes fueron del Valle de Aburrá, 50,2 % hombres, 65,4 % altruistas, 59,3 % de primera vez y 81,2 % captados fuera de las instalaciones del Banco. La seropositividad general de VIH fue 0,275 % (IC 95 %=0,25-0,30), en las frecuencias específicas fue del 0,324 % en hombres y 0,224 % en mujeres; 0,299 % en donantes con edad entre 18 - 40 años, 0,212% en los de 41 - 65 años, 0,333 % en los de primera vez; 0,213 % en los no repetitivos y 0,149 % en los donantes repetitivos. Se concluye que la seropositividad de la infección fue similar en comparación con investigaciones previas, con un descenso importante desde el 2013. El riesgo de infección fue estadísticamente mayor en los hombres, los menores de 40 años y donantes de primera vez. Esto es importante para conocer la línea base y evaluar acciones de prevención en la población de estudio, orientar estudios etiológicos y mejorar políticas de hemovigilancia.

ABSTRACT The objective of this study was to estimate the seropositivity of HIV and associated factors in donors of a blood bank in the city of Medellín- Colombia, 2005 - 2018. A cross-sectional study in 166 603 donors of the Blood Bank of the School of Microbiology. Estimates were based proportions and odds ratios with 95 % confidence intervals. The majority of donors were from the Aburrá Valley, 50.2 % men, 65.4 % altruistic, 59.3 % first time and 81.2 % received outside the blood bank. The general seropositivity of HIV was 0.275 % (95 % CI = 0.25-0.30), the specific proportions were 0.324 % in men and 0.224 % in women; 0.299 % in donors with 18-40 years old and 0.212 % in the group of41-6540 years old, and 0.333 % in donors of first-time, 0.213 % in non-repetitive and 0.149 % in repetitive donors. The conclusion was that the seropositivity of the infection was similar in comparison with previous investigations, with a significant decrease since 2013. The risk of infection was statistically higher in men, under 40 years and first-time donors. All this takes is important to know the baseline and evaluate prevention actions in the study population, guide etiological studies, and improve hemovigilance policies.

Programa de superación profesional en medicina transfusional para la especialidad Anestesiología y Reanimación / A professional upgrading program in transfusion medicine for the specialty of anesthesiology and resuscitation

Introducción: La superación profesional debe propiciar el desarrollo de competencias para un mejor desempeño laboral. El desempeño competente del personal médico en medicina transfusional requiere profundos conocimientos teóricos y prácticos que no recibe durante el proceso formativo. Objetivo: Diseñar un programa de posgrado dirigido a la especialidad Anestesiología y Reanimación para el desarrollo de la competencia en medicina transfusional. Métodos: Estudio realizado en la Universidad de Ciencias Médicas de Camagüey entre marzo 2016 a diciembre de 2018. Se efectuó un análisis documental para identificar los componentes de la competencia. Se investigaron las actividades provinciales de superación profesional sobre medicina transfusional y, en el programa de la residencia, las habilidades relacionadas. Se identificaron mediante cuestionario las necesidades sentidas de aprendizaje, estas guiaron el diseño del programa de posgrado que se validó por criterio de especialistas y un preexperimento. Resultados: Fueron pocas las actividades de superación profesional referidas sobre medicina transfusional; el programa de la residencia solo incluye algunas habilidades. Se diseñó el programa de un diplomado basado en las etapas de planificación curricular en educación médica, las necesidades de aprendizaje identificadas y los componentes de la competencia. La mayoría de los especialistas lo evaluaron de excelente. En el preexperimento la valoración de los educandos fue positiva. Conclusiones: El programa del diplomado se corresponde con las proyecciones, normativas y estrategias del MINSAP para el desempeño profesional competente en medicina transfusional en la especialidad Anestesiología y Reanimación; está avalado científica, técnica y pedagógicamente y es adaptable a otros contextos(AU)

Introduction: Professional upgrading should promote the development of skills for better occupational performance. The competent performance of the medical personnel in transfusion medicine requires in-depth theoretical and practical knowledge that they do not receive during the training process. Objective: To design a postgraduate program aimed at the specialty Anesthesiology and Resuscitation for the development of competence in transfusion medicine. Methods: Study carried out at the University of Medical Sciences of Camagüey, between March 2016 and December 2018. A documental analysis was carried out to identify the competence components. We investigated the provincial professional upgrading activities on transfusion medicine together with related skill in the residence program, related skills. We identified, though questionnaire, the learning needs experienced; these guided the design of the postgraduate program, which was validated by criteria of specialists and through pre-experiment. Results: There were few professional upgrading activities referred to about transfusion medicine; the residence program includes only some skills. A diploma course program was designed based on the stages of curricular planning in medical education, the learning needs identified, and the competence components. Most of the specialists evaluated it as excellent. In the pre-experiment, the evaluation by the students was positive. Conclusions: The diploma course program is in correspondence with the projections, regulations and strategies of the MINSAP for competent professional performance in transfusion medicine within the specialty of Anesthesiology and Resuscitation; it is scientifically, technically and pedagogically validated and is adaptable to other settings(AU)

Usage of blood and blood product / Монголын Анагаах Ухаан

Background@#A blood product is any therapeutic substance derived from human blood, including whole blood and other blood components for transfusion, and plasma-derived medicinal products. Medicinal (medical therapeutic) products derived from human donations of blood and plasma play a critical role in health care. Safe, effective and quality-assured blood products contribute to improving and saving millions of lives every year, as they: address child mortality and maternal health, dramatically improve the life expectancy and quality of life of patients suffering from life-threatening inherited disorders, such as haemophilia, thalassaemia and immune deficiency, and acquired conditions such as cancer and traumatic haemorrhage and support complex medical and surgical procedures, including transplantation. An insufficient or unsafe blood supply for transfusion has a negative impact on the effectiveness of key health services and programmes to provide appropriate patient care in numerous acute and chronic conditions. Ensuring access of all patients who require transfusion to safe, effective and quality-assured blood products is a key component of an effective health system and vital for patient safety.</br> Although the number of blood donors is increasing, there are still insufficient human and financial resources for encouraging the growing demand of blood and blood products and new blood donors. @*Material and Methods@#We collected secondary data by using using the order forms of hospitals that used blood and blood products registered in the National Center for Blood Transfusion Research in 2017-2019 in accordance with the retrospective survey method. </br> In total 34,119 hospital order information sheet was entered into computer in excel program, and converted into SPSS 23 software, descriptive parameters were calculated and analyzed. @*Results@#Compare to the 2017 (n=9076), the demand of blood product was increased by 21.8%, and 54.8% in 2019. There are 51.9% (95%CI: 51.2-52.5) of total users are male, which is statistically significant. The mean age of blood product users were aged 48.58±21.32, the youngest user was aged 1 and the oldest age was 99. The demand of blood products were increased by growing of the age of users. The product usage of age group of 46-55 was 17.8% and has trend to increase year by year. In total, 11.3% of total blood product was utilized for children and 72.3% of them were aged less than 5 years old. 73.0% of total blood products were utilized in specialized hospitals, 14.6 % of them were used in aimag and district level hospitals and 11.3% of them were used in private clinics. 24.4% of blood products utilization was used for diseases of digestive system (К00-К93), 22.1% of them were used for diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism, and 19.5% of them were used for the cancer (C00-C97) disease patient’s treatment. @*Conclusion@#Since after new treatment guidance was introduced the blood and blood products usage had been increased.

Red blood cell prescription and recognition of transfusion reactions by pediatricians / Prescrição de hemácias e reconhecimento de reações transfusionais por pediatras

ABSTRACT Objective To assess the level of knowledge of emergency pediatricians on red blood cell transfusions and their reactions. Methods Written survey with emergency pediatricians from a pediatric hospital. Results Less than 20% of pediatricians showed appropriate knowledge on prescribing red blood cells and recognition of transfusion reactions. There was no significant statistical regarding time since graduation and blood transfusion classes in undergraduate studies or during medical residency. Conclusion Pediatricians have insufficient knowledge about red blood cell transfusions and recognition of transfusion reactions.

RESUMO Objetivo Avaliar o conhecimento de pediatras emergencistas sobre transfusão de concentrados de hemácias e reações transfusionais. Métodos Aplicação de formulário para pediatras emergencistas de um hospital pediátrico. Resultados Menos de 20% dos participantes demonstraram conhecimento adequado sobre prescrição de concentrados de hemácias e reconhecimento de reações transfusionais. Não houve diferença estatística significativa quando avaliados o tempo de formação profissional e o fato de ter recebido aula de hemoterapia na graduação ou na residência médica. Conclusão Os pediatras têm conhecimento insuficiente sobre prescrição de concentrados de hemácias e reconhecimento de reações transfusionais.

Prescription of red cell concentrates by emergency physicians

SUMMARY OBJECTIVE To evaluate the adequacy of the prescription of red cell concentrates by emergency physicians. METHODS A cross-sectional study based on the survey of transfusion requests records completed by emergency physicians, from May/2018 to April/2019, in an emergency hospital. Adequacy in the indication, volume, and subtype (filtered, irradiated, and washed) of prescribed erythrocytes were evaluated. To compare the qualitative data, we used the χ2 test. The significance level adopted was 5%. RESULTS One thousand and twenty-two transfusions were evaluated. The indication, volume, and subtypes were correct in 72.7%, 45.9%, and 81.6% respectively. Transfusion in symptomatic patients presented superior adequacy when compared to asymptomatic individuals with significant statistical difference (indication: 79,6% vs 67.2%, p <0.001; Volume: 63.5% vs 31.7%, p <0.001; subtype: 85.3% vs 78.7%, p 0.006). Among clinical situations, there were more errors in sepsis (39.7%) and pneumonia (36.3%). More than half of the prescriptions presented excessive volume, raising the risk of circulatory overload, observing that the mean age was 60.6 years. The specific analysis of the prescribed subtypes showed adequacy of 17.9% in the filtered, 1.7% in the irradiated, and none in the washed. Thirty transfusions should have been filtered, but the prescriber did not request the subtype. CONCLUSION One hypothesis for the observed inaccuracies is inadequate medical training on the subject, both in undergraduate and medical residency, associated with a lack of continuing education on transfusion protocols. The transfusion Committee received the results of this study with a proposal for continuing education measures on transfusion hemotherapy.

RESUMO OBJETIVO Avaliar a adequação da prescrição de concentrados de hemácias por médicos emergencistas. MÉTODOS Estudo transversal por levantamento de fichas de requisição de transfusões preenchidas por médicos emergencistas, no período de maio de 2018 a abril de 2019, em um hospital de emergências. Foram avaliadas as adequações na indicação, volume e subtipo (filtradas, irradiadas e lavadas) de hemácias prescritas. Para comparação dos dados qualitativos, utilizamos o teste de χ2. O nível de significância adotado foi de 5%. RESULTADOS Foram avaliadas 1.022 transfusões. A indicação, o volume e os subtipos estavam corretos em 72,7%, 45,9% e 81,6%, respectivamente. A transfusão prescrita em pacientes sintomáticos apresentou adequação superior quando comparada aos assintomáticos, com diferença estatística significativa (indicação: 79,6% vs 67,2% - p<0,001; volume: 63,5% vs 31,7% - p<0,001; subtipo: 85,3% vs 78,7% - p 0,006). Entre as situações clínicas, ocorreram mais erros na sepse (39,7%) e pneumonia (36,3%). Mais da metade das prescrições apresentavam volume excessivo, elevando o risco de sobrecarga circulatória, observando-se que a média da idade foi 60,6 anos. A análise específica dos subtipos prescritos apresentou adequação de 17,9% nas filtradas, 1,7% nas irradiadas e nenhuma das lavadas. Trinta transfusões deveriam ter sido filtradas, porém o prescritor não solicitou o subtipo. CONCLUSÃO Uma hipótese para as incorreções observadas é a formação médica inadequada sobre o assunto, tanto na graduação como na residência médica, associada à falta de atualização nos protocolos transfusionais. O comitê transfusional recebeu os resultados deste estudo com proposta de medidas de educação permanente sobre hemoterapia transfusional.